Perfil da dor lombar em trabalhadores dos restaurantes de uma universidade pública do sul do Brasil / Lower back pain profile in restaurant workers at a public university in southern Brazil

A realização das tarefas dos trabalhadores em restaurantes universitários (RUs) envolve movimentos repetitivos de coluna, levantamento de pesos excessivos e permanência na postura em pé por períodos prolongados de tempo, sendo indicada avaliação da região lombar desses trabalhadores. Assim, o objetivo deste estudo foi traçar o perfil da dor lombar em trabalhadores dos RUs de uma Universidade Pública do Sul do Brasil. Trata-se de estudo quantitativo observacional de corte transversal, no qual foram selecionados participantes de 18 a 59 anos, de ambos os sexos, que exerciam alguma função dentro dos restaurantes de uma universidade do sul do Brasil e que relataram presença dor lombar. Os participantes foram avaliados, por: questionário sociodemográfico, escala visual numérica da dor (EVN), amplitude de movimento (ADM) da coluna lombar e questionário Start Back Screening Tool Brasil (SBST). Os resultados são apresentados em frequência absoluta e relativa, correlação de Spearman, e as variáveis numéricas em média e desvio padrão ou mediana, mínimo, máximo. Foram incluídos no estudo 28 participantes sendo 71,4% mulheres, que possuíam média de idade de 36,3 (±10,8) anos. O relato de dor acima de 4 na EVN foi de 71,4% dos participantes e todos possuíam diminuição da ADM em todos os movimentos avaliados na coluna lombar. A maioria (71,4%) apresentou baixo risco para fatores psicossociais pelo SBST. O perfil dos trabalhadores de restaurantes da universidade avaliada é caracterizado por ser prioritariamente realizado por mulheres, sendo que estas trabalhadoras apresentaram quadro álgico intenso e limitação dos movimentos articulares na região lombar.

The tasks that workers in university restaurants (URs) perform involves repetitive movements of the back, lifting excessive weight, remaining in a standing posture for prolonged periods of time, and, thus, an evaluation of the lumbar region of these workers is indicated. Therefore, the objective of this study was to outline the profile of lower back pain in workers from the URs of a Public University in the South of Brazil. This is a cross-sectional, observational, quantitative study, in which participants aged 18 to 59 years, of both sexes, who performed some function within the restaurants of a university in southern Brazil and who reported the presence of lower back pain were selected. Participants were evaluated by a sociodemographic questionnaire, a visual analogue scale (VAS) for pain, a range of motion (ROM) of the lumbar spine evaluation, and the Brazilian Start Back Screening Tool (SBST) questionnaire. Results are presented as absolute and relative frequencies, with a Spearman correlation, and numerical variables as mean and standard deviation or median, minimum, and maximum. Twenty-eight participants were included in the study, 71.4% of whom were women, with a mean age of 36.3 (±10.8) years old. The report of pain above 4 in the VAS was 71.4% of the participants and all had a decrease in ROM in all movements evaluated in the lumbar spine. Most (71.4%) had low risk for psychosocial factors by SBST. The profile of restaurant workers at the evaluated university is characterized by being primarily performed by women, and these workers presented severe pain and limited joint movements in their lumbar region.

Sensitivity of Laségue Sign and Slump Test in Hernia and Disc Bulging Diagnoses Compared with Magnetic Resonance Imaging / Sensibilidade das manobras de Laségue e de slump nos diagnósticos de hérnia e abaulamento discal em comparação com ressonância magnética

Abstract Objective To show the accuracy of the most used maneuvers in the clinical diagnosis of lumbosciatalgia, the slump test and the Laségue sign. Methods In order to perform the present study, 101 patients with magnetic resonance imaging (MRI) discopathy (gold standard) were selected and had their medical records reviewed to identify which had the positive maneuvers on the initial physical examination. Results The sensitivity found for the slump test and the Laségue sign in the diagnosis of disc herniation was 55.3% and 18.1%, respectively. Nonetheless, when they were compared with each other for the diagnosis of disc bulging, the sensitivity obtained was of 85.7% for the slump test and of 28.6% for the Laségue sign. Conclusion Comparing both clinical exams with MRI, it was found that the slump test presents superior sensitivity compared with the Laségue sign for both the diagnosis of hernia and disc bulging, and should be more present in clinical practice.

Resumo Objetivo Mostrar a acurácia das manobras mais usadas no diagnóstico clínico da lombociatalgia, a manobra de slump ea de Laségue. Métodos Para a realização do presente estudo, foram selecionados 101 pacientes com discopatia na ressonância magnética (RM) (padrão ouro), sendo posteriormente realizada a revisão dos prontuários para identificar quais tiveram as manobras positivas no exame físico inicial. Resultados A sensibilidade encontrada para as manobras de slump e Laségue no diagnóstico de hérnia discal foi respectivamente 55,3% e 18,1%. Já quando comparamos as manobras para o diagnóstico de abaulamento discal, a sensibilidade obtida foi de 85,7% para a manobra de slump e de 28,6% para a manobra de Laségue. Conclusão Foi constatado que a manobra de slump apresenta sensibilidade superior à da manobra de Laségue tanto para o diagnóstico de hérnia quanto para o de abaulamento discal quando comparadas a RM, e deveria estar mais presente na prática clínica.

Survey on Work-related Pain in Photographers and Effects of Acupuncture Treatments / 全日本鍼灸学会雑誌

[Objective] Photographers perform a variety of tasks, including taking photographs for extended periods of time, using personal computers to organize photographic data, and preparing and transporting their equipment. Although photographers may exhibit a variety of symptoms, there have been no reports on investigations of pain or disease in photographers. In this study, we conducted a questionnaire survey on the actual status of work-related pain in photographers. We, then, performed acupuncture and evaluated the effects in subjects for pain or stiffness in the neck and shoulders, which was the most common chief complaint in the questionnaire.[Subjects and Methods] The survey was sent to 138 professional photographers. The survey included seven items, such as symptoms experienced during work activities and the content of the work. Among the respondents who reported chief complaints of pain in the neck and shoulder regions, six (one male and five females) opted to receive acupuncture treatment. We used the visual analog scale (VAS) scores to determine the amount of shoulder stiffness and tenderness in the shoulders and neck, as well as induration, before and immediately after treatment.[Results] Responses were obtained from 60.1% subjects. The most common chief complaint involved the neck and shoulder region in 86% of subjects. In the analysis of sex differences, the most common chief complaint in females was in the neck and shoulder region, whereas the most common chief complaint in males was in the lower back region. In the assessment of effects of acupuncture, the VAS scores for shoulder stiffness decreased after acupuncture (p < 0.05) and tenderness and induration scores decreased after acupuncture (p < 0.05).[Discussion and Conclusion] Low muscle strength may be a contributing factor for a higher complaint of neck and shoulder pain and stiffness in females. A higher complaint of pain and stiffness in the lower back region in males may be attributable to a higher load on the lower back region because they tend to have poor posture owing to height differences with the object being photographed. These results suggest that acupuncture is useful for work-related pain in the neck and shoulder region, which is the most common chief complaint in photographers.

Assessment of back pain and disability status among automotive industry workers, in Ethiopia

Background:Back pain is a very common public health problem in the manufacturing industry and a major cause of disability that affects work performance and wellbeing. Currently, manufacturing sectors in Ethiopia, including automotive manufacturing is growing well but there is poor culture of work place safety. The aim of this study wasto assess the prevalence of back pain and disability status at Bishoftu automotive industry workers.Methods:A cross sectional study was conducted among 412 workers in a period of February to May 2018. Simple random sampling technique was applied to select participants. Data was collected by face-to-face interview using standard Nordic and Oswestry back pain disability index tools. Analysis was done by using SPSS version 24. Bivariate and multivariate logistic regression analyses were used to determine associations.Results:Prevalence of work related back pain among automotive production factory workers during last 12 months and last seven days were 51.7% and 25% respectively and related disability was 87%. The risk factors of the work related back pain that were identified include; work experience (11-15 years) AOR: 0.02, 95% CI (0.001-0.46), tasks that involve bending and twisting AOR: 2.03, 95% CI (1.19-3.45) and lifting of heavy loads AOR: 4.89, 95% CI (2.83-8.47).Conclusions:High prevalence of back pain among automotive industry workers was seen. Furthermore, this study verified workers with back pain and more specifically those working in tasks that involve with the identified associated risk factors were suffer from disability. The problem should need more attention to promote the health and safety of workers

Literature Review on Prevalence, Risk Factors and, Evaluation of Acute Lower Back Pain

Background: Acute back pain is any pain located at the back that lasts for less than 4 weeks duration. Theprevalence is fair with as many as 84% of the adult population around the globe experience back pain at somepoint in life and is often self-limiting. However, in few selected patients it may serve as indicator of a seriousunderlying disease making it crucial to properly evaluate, characterize and address this concern. Objectives: Inthis review we intend to explore the prevalence, risk factors and highlight the available methods using diagnosticimaging modalities to evaluate and address this condition. Materials and Methods: A review of relevant articlespublished from 1987 onwards in English language was done using the electronic databases of PubMed Pico and,Google Scholar with preset keywords. Conclusion: Acute back pain prevalence range between 22 to 48 percentand risk factors are non-modifiable such as advanced age and female gender while modifiable risk factors areobesity, smoking, low education, sedentary lifestyle, etc. Employment related factors such as physically strenuouswork also increase the risk of developing back pain. Notably, under-appreciated risk factors includingpsychological risk factors such as anxiety should be screened for while evaluating patients. Evaluation of backpain mostly relies on comprehensive history and physical examination, as most cases are self-limited. Diagnosticimaging is only recommended in cases presenting with red flag symptoms.

Current Situation of Lower Back Pain Prevention Education at Manual Therapist Colleges / 日本温泉気候物理医学会雑誌

  Objective: The purpose of this research is to clarify whether the current situation of the lower back pain prevention education of manual therapists is different between the colleges for sighted persons and those for the visually impaired. This research investigated the current situation of the guidance using an up-and-down type treatment table and the current situation of lower back pain prevention education at manual therapist colleges in Japan.  Method: A mail-in survey was conducted for 85 colleges providing a manual therapist training program. For data analysis, descriptive statistics were used to calculate proportions. The type of colleges and implementation of lower back pain prevention education were chi-square tested against other questions.  Results: Of the 52 colleges that responded to the survey form, those for sighted persons which offered lower back pain prevention education numbered 8 of 8 (100%), while such institutions for the visually impaired were 22 of 44 (50%) (p<0.001). Among the 51 colleges responding to the question about the up-and-down treatment table, 1 in 8 (12.5%) institutions for the sighted used the device, as did 43 of 43 (100%) (p<0.001) institutions for the visually impaired. Of the 44 colleges which use the up-and-down type treatment table, 38 (86.4%) taught the height of the treatment table and 43 (97.7%) taught the posture, but there was no common guidance method used by a majority of the colleges. Among the 44 colleges using the up-and-down type treatment table, those which provided lower back pain prevention education and taught the height of the treatment table were 23 of 23 (100％) (p＝0.008).  Discussion: Manual therapist colleges have paid attention to teaching a posture, but that instruction is not connected to lower back pain prevention by teaching the height of a treatment table. Training colleges need a common teaching method to give systematic lower back pain prevention education.  Conclusion: Manual therapist training differs by environment for sighted and visually impaired students, suggesting that teaching method of lower back pain prevention education is different.

Prevalence and Risk Factors for low back pain among Nurses at Benghazi Medical Centre, Libya

Lower back pain (LBP) is recognized as a cause of morbidity in developed nations in different occupational situations. Health care workers (HCWs), in particular nurses, are especially vulne-rable to LBP. About 60­80% of the general people suffer from LBP at some time during their lives. However, there is not enough care about workplace health and safety problems facing the health care workforce in developing nations, such as Libya. Thus, this study aimed to find out the status of low back pain and factors affecting pain among the nurses in Benghazi Medical Centre (BMC), Libya. Cross-sectional study was conducted on BMC in 2018. The data was collected by a self-administered questionnaire. Chi-square was used to determine the association between associated risk factors and LBP prevalence (p<0.05). There is a high prevalence (79%) of low back pain among nurses in BMC. Individual and work-related factors were found as risk factors for LBP. In Libya, nurses are considered as a critical health and safety concern, as a result of the weakness of policies in healthcare organizations. Consequently, a proper no weight lifting policy should be considered. If not, proper manual lifting must be implemented.

A Cross-Sectional Study Determining Pain in Lower Back and Calf Muscles among Females Due to High Heel Shoe Wear

To determine pain in lower back and calf muscles among females due to high heels shoe wear. Methodology: A sample size of 87 females working women and students were recruited on the basis of the purposive sampling technique. Participants were requested to wear 5 cm stiletto high heels and they were asked to walk on treadmill at the pace of 4km/hr for 20 minutes. Modified McGill Questionnaire for pain measurement was used as a tool before and after test data collection. Results: In this study observation of muscular pain was significant in lower limb and lower back muscles due to high heels i.e. 29.6% and 24.7% respectively. Conclusion: Back and lower limbs musculature pain contribute only 8.6% whereas, only back pain had been observed in 9.9%. Paired sample t-test was used to determine pain before and after test was significant with p-value 0.000.

Relación entre lumbalgia y sobrepeso/ obesidad: dos problemas de salud pública / Relationship Between Low Back Pain and Overweight/Obesity: Two Public Health Problems / Relação entre lumbago e sobrepeso-obesidade: dois problemas de saúde pública

Resumen: La lumbalgia y el sobrepeso-obesidad son patologías que se han constituido en tema de interés en salud pública, dado el incremento de incidencia y prevalencia de estas enfermedades en la población mundial. Investigaciones al respecto han sido realizadas especialmente en población anglosajona. Este artículo presenta un estudio analítico de corte transversal, en el que se incluyeron 100 pacientes escogidos con un muestreo por conveniencia, con diagnóstico de lumbalgia, y atendidos en la consulta externa institucional de Ortopedia-Columna del Hospital Militar Central, durante el periodo de abril-junio de 2015. Se analizaron variables sociodemográficas y relacionadas con severidad del dolor, sobrepeso-obesidad e imbalance muscular, variables que se consideraban factores asociados a la presentación y severidad de lumbalgia. De los pacientes analizados, el 52 % fueron mujeres y el 48 %, hombres. Se encontró que las mujeres con porcentaje de grasa corporal elevado tienen un riesgo mayor de padecer dolor lumbar severo, y los hombres con porcentaje de grasa corporal bajo tienen menos riesgo de presentar esta afección. El índice de masa corporal (IMC) para este estudio no pudo predecir la intensidad de dolor lumbar; sin embargo, se logró observar que ser hombre mayor de 50 años es un factor de riesgo para presentar lumbalgia severa.

Abstract: Low back pain and overweight/obesity have become a topic of interest in public health, given the increased incidence and prevalence of these pathologies in the world population. Research in this regard has been carried out, especially in the Anglo-Saxon population. This article presents a cross-sectional analytical study, which included 100 patients chosen by convenience sampling, with a diagnosis of low back pain and attending the institutional Orthopedics-Column outpatient clinic of the Hospital Militar Central during April-June 2015. Sociodemographic variables related to pain severity, overweight/obesity, and muscular imbalance were analyzed, as they were considered factors associated with the occurrence and severity of low back pain. Of the patients analyzed, 52% were women and 48 % men. It was found that women with high fat percentage have a higher risk of severe low back pain, while men with low fat percentage have a lower risk of having this condition. Body mass index (BMI) for this study could not predict the intensity of low back pain; however, it was observed that being a man older than 50 is a risk factor for severe low back pain.

Resumo: O lumbago e o sobrepeso-obesidade são patologias que se constituem em tema de interesse em saúde pública, tendo em vista o aumento de incidência e a prevalência dessas doenças na população em todo o mundo. Pesquisas sobre isso têm sido realizadas, em especial, com população anglo-sa-xã. Este artigo apresenta um estudo analitico, de corte transversal, do qual participaram 100 pacientes selecionados por conveniência, com diagnóstico de lumbago, e atendidos em consulta institucional de Ortopedia-Coluna do Hospital Militar Central, entre abril e junho de 2015. Foram analisadas variáveis sociodemográficas e relacionadas com severidade da dor, sobrepeso-obesidade e desequilíbrio muscular, variáveis consideradas fatores associados com a apresentação e a severidade de lumbago. Dos pacientes analisados, 52% eram mulheres e 48%, homens. Foi verificado que as mulheres com porcentagem de gordura elevada têm um risco maior de padecer dor lombar severa, e os homens com porcentagem de gordura baixa têm menos risco de apresentar essa condição. O indice de massa corporal para este estudo não pode predizer a intensidade de dor lombar; contudo, pôde-se observar que ser homem com mais de 50 anos é um fator de risco para apresentar lumbago grave.

Effect of Visual Feedback Squat Motion on Core Muscles Thickness of Young People with Lower Back Pain

PURPOSE: This study examined the effect of visual feedback squat on the core muscle thickness of young adults experiencing back pain. METHODS: Thirty adult men and women who experienced back pain were assigned randomly to 15 members of the visual feedback squat group (VSG) and 15 of the normal squat group (NSG) to train three times a week for a total of eight weeks. The core muscle thickness was compared prior to the test for four weeks and eight weeks after the test by dividing it into warm-up exercise, main exercise, and 10 minutes finishing exercise. Before, and four weeks and eight weeks later, the thickness of the core muscle was compared using an ultrasonic imaging system. Repeated measured ANOVA was performed to compare the groups, and a Bonferroni test was performed as a post-hoc test to assess the significance of the timing of the measurements in each group according to the periods. An independent t-test was conducted to test the significance between the groups according to the measurement points. RESULTS: A significant change in the main effects of time and interactions of the time difference in muscle thickness of transvers abdominis were observed between the visual feedback squat and control groups according to the measurement point (p0.05). CONCLUSION: These findings suggest that visual feedback squat exercise is expected to have positive effects on the development of transverse abdominis in core muscles.

Comparison of Lumbopelvic Motions During Hip Medial Rotation Depending on Sex Differences and Chronic Lower Back Pain

PURPOSE: Hip rotation testing is important in the evaluation of chronic back pain. The purpose of this study was to investigate hip and lumbopelvic movement during hip medial rotation (HMR) in individuals with chronic lower back pain (CLBP). METHODS: This study targeted 112 subjects in total: 28 healthy males and 28 healthy females, and 27 males with CLBP and 29 females with CLBP. Motion-capture device was used to measure the hip medial rotation angle (HMRA), lumbopelvic rotation angle (LPRA), and the rotation angle of the hip when lumbopelvic rotation starts during hip medial rotation. RESULTS: When evaluating the healthy males and females using the hip medial rotation test (HMRT), healthy males showed a smaller HMRA than did healthy females (p<0.05). When evaluating the healthy males and the males with CLBP using the HMRT, males with CLBP showed a smaller HMRA and more lumbopelvic movements than did healthy males (p<0.05) in addition, their lumbopelvic movements occurred earlier during HMR (p<0.05). Finally, when evaluating the males and the females with CLBP using the HMRT, males with CLBP showed a smaller HMRA and more lumbopelvic movements (p<0.05), and their lumbopelvic movements occurred earlier during HMR (p<0.05). CONCLUSION: The HMRT is an important test for the evaluation of males, and especially males with CLBP, as they often experience an increased LPRA and decreased HMRA, with lumbopelvic movement occurring earlier during HMR when compared to other groups.

The Effects of Stretching and Strengthening Exercise on the Pain, Pelvic Tilt, Functional Disability Index, and Balance Ability of Patients with Chronic Lower Back Pain

PURPOSE: This study examined the effects of stretching and strengthening exercises on the pain, pelvic tilt (PT), functional disability, and balance of patients with chronic lower back pain (CLBP). METHODS: A total of 42 patients with CLBP were randomly divided randomly into either experimental group I (EG I, n=21), who received stretching exercise, or experimental group II (EG II, n=21), who received strengthening exercise. Both interventions were applied three times a week for eight weeks. Assessments were made with a visual analogue scale (VAS), PT, Oswestry disability index (ODI), and Berg's balance scale (BBS) before and after the eight weeks intervention period. A paired t-test was conducted to compare the within-group changes before and after the intervention. An independent t-test was used compare the between-group difference. The statistical significance level was set to α=0.05 for all variables. RESULTS: The EG I and II showed significant within-group changes in the VAS, PT, ODI, and BBS (p<0.05). The changes in VAS, PT, ODI, and BBS were similar regardless of the exercise form. CONCLUSION: In this study, the application of stretching and strengthening exercise for subjects who complain of CLBP was effective in changing the level of pain, PT, functional disability, and balance.

Current Situation of Lower Back Pain Prevention Education at Manual Therapist Colleges / 日本温泉気候物理医学会雑誌

  Objective: The purpose of this research is to clarify whether the current situation of the lower back pain prevention education of manual therapists is different between the colleges for sighted persons and those for the visually impaired. This research investigated the current situation of the guidance using an up-and-down type treatment table and the current situation of lower back pain prevention education at manual therapist colleges in Japan.  Method: A mail-in survey was conducted for 85 colleges providing a manual therapist training program. For data analysis, descriptive statistics were used to calculate proportions. The type of colleges and implementation of lower back pain prevention education were chi-square tested against other questions.  Results: Of the 52 colleges that responded to the survey form, those for sighted persons which offered lower back pain prevention education numbered 8 of 8 (100%), while such institutions for the visually impaired were 22 of 44 (50%) (p<0.001). Among the 51 colleges responding to the question about the up-and-down treatment table, 1 in 8 (12.5%) institutions for the sighted used the device, as did 43 of 43 (100%) (p<0.001) institutions for the visually impaired. Of the 44 colleges which use the up-and-down type treatment table, 38 (86.4%) taught the height of the treatment table and 43 (97.7%) taught the posture, but there was no common guidance method used by a majority of the colleges. Among the 44 colleges using the up-and-down type treatment table, those which provided lower back pain prevention education and taught the height of the treatment table were 23 of 23 (100％) (p＝0.008).  Discussion: Manual therapist colleges have paid attention to teaching a posture, but that instruction is not connected to lower back pain prevention by teaching the height of a treatment table. Training colleges need a common teaching method to give systematic lower back pain prevention education.  Conclusion: Manual therapist training differs by environment for sighted and visually impaired students, suggesting that teaching method of lower back pain prevention education is different.

Metabolic and endocrinal effects of epidural glucocorticoid injections

INTRODUCTION@#Epidural steroid injections are an integral part of nonsurgical management of radicular pain from lumbar spine disorders. We studied the effect of dexamethasone 8 mg epidural injections on the hypothalamic-pituitary-adrenal axis and serum glucose control of Asian patients.@*METHODS@#18 patients were recruited: six diabetics and 12 non-diabetics. Each patient received a total of dexamethasone 8 mg mixed with a local anaesthetic solution of lignocaine or bupivacaine, delivered into the epidural space. Levels of plasma cortisol, adrenocorticotropic hormone (ACTH), serum glucose after an overnight fast and two-hour postprandial glucose, as well as weight, body mass index, blood pressure and heart rate were measured within one week prior to the procedure (baseline) and at one, seven and 21 days after the procedure.@*RESULTS@#Median fasting blood glucose levels were significantly higher on post-procedure Day 1 than at baseline. However, there was no significant change in median two-hour postprandial blood glucose from baseline levels. At seven and 21 days, there was no significant difference in fasting or two-hour postprandial glucose levels. Both ACTH and serum cortisol were significantly reduced on Day 1 compared to baseline in all patients. There was no significant difference in ACTH and serum cortisol levels from baseline at Days 7 and 21.@*CONCLUSION@#Our study shows that epidural steroid injections with dexamethasone have a real, albeit limited, side effect on glucose and cortisol homeostasis in an Asian population presenting with lower back pain or sciatica.

Therapeutic Observation of Bai Xiao Moxibustion plus Electroacupuncture for Lumbar Intervertebral Disc Herniation / 上海针灸杂志

Objective To observe the clinical efficacy of Bai Xiao moxibustion plus electroacupuncture in treating lumbar intervertebral disc herniation (LIDH). Method Ninety-six LIDH patients were randomized into a treatment group and a control group, 48 cases each. The treatment group was intervened by Bai Xiao moxibustion plus electroacupuncture, while the control group was intervened by electroacupuncture alone. Before and after the treatment, the lower back pain scores of Japanese Orthopedic Association (JOA) and Visual Analogue Scale (VAS) were evaluated, and the clinical efficacies of the two groups were compared. Result The JOA and VAS lower back pain scores were changed significantly after the treatment in both groups (P<0.05). After the treatment, the JOA and VAS lower back pain scores of the treatment group were significantly different from those of the control group (P<0.05). The pain release time was (2.95±0.59)d after the intervention in the treatment group versus (4.26±0.68)d in the control group, and the between-group difference was statistically significant (P<0.05). The total effective rate was 95.7％ in the treatment group versus 91.7％ in the control group, and the between-group difference was statistically significant (P<0.05). Conclusion Bai Xiao moxibustion plus electroacupuncture is an effective method in treating LIDH and it can reduce the lower back pain.

Efectividad de la acupuntura en el tratamiento de la sacrolumbalgia / Effectiveness of Acupuncture in the Treatment of Low Back Pain

Introducción: la acupuntura constituye una terapia alternativa para aliviar distintas afecciones y mejorar la calidad de vida de los pacientes. Objetivo: evaluar el efecto terapéutico de la acupuntura en el tratamiento a pacientes con sacrolumbalgia. Métodos: se realizó una investigación cuasi experimental con 50 pacientes atendidos en la Sala de Rehabilitación de la Policlínica Pedro del Toro Saad, remitidos de los consultorios y con diagnóstico de sacrolumbalagia. El tratamiento consistió en tres sesiones semanales de acupuntura para un total de 12, que permitieron monitorear el comportamiento del dolor y la movilidad, así como, su eficacia en las afecciones del sistema osteomioarticular. Se empleó la distribución de frecuencias y las tablas de contingencia del paquete estadístico Statistics Program for Social Sciences 20.0 (2011) para el procesamiento de los datos. Resultados: se observó que el sexo femenino, así como, el grupo de edad entre 41 y 50 años resultan los más afectados con la enfermedad, que representó el 58% y 46%, respectivamente. Los pacientes tratados tuvieron una evolución satisfactoria con un total de seis a doce sesiones. Con la aplicación de la terapia el comportamiento de dolor se evaluó de bueno en 37 pacientes (74%) y 42 pudieron realizar movimientos amplios (84%). Conclusiones: se evidenció la efectividad de la acupuntura en el tratamiento de la sacrolumbalgia, se logró que, al terminar la terapia, un número significativo de pacientes pudieran realizar amplios movimientos de cadera y miembros inferiores.

Introduction: acupuncture is an alternative therapy to relieve different affection and to improve the quality of life of patients. Objective: to evaluate the therapeutic effect of acupuncture in the treatment of patients with low back pain. Methods: a quasi-experimental study with 50 patients treated at the rehabilitation ward of the Pedro del Toro Saad polyclinic, referred from clinics and diagnosed with low back pain was conducted. Treatment consisted of three weekly acupuncture sessions for 12, which allowed monitoring the behavior of pain and mobility, as well as its efficacy in diseases of osteomioarticular system. Frequency distributions and contingency tables Statistics Program for Social Sciences 20.0 (2011) for processing the data was used. Results: female sex and the age group between 41 and 50 years old were the most affected by the disease, representing 58% and 46% respectively. Treated patients had a satisfactory evolution with a total of six to 12 sessions. With the application of the treatment of pain, behavior was assessed as good in 37 patients and 42 were able to perform extensive movements. Conclusions: the effectiveness of acupuncture in the treatment of low back pain was evident; making the completion of therapy a significant number of patients could make extensive movements of hip and lower limbs.

Transcultural adaptation into Portuguese of an instrument for pain evaluation based on the biopsychosocial model / Adaptação transcultural para a língua portuguesa de um instrumento de orientação para avaliação da dor

Abstract Introduction: Pain is an individual experience influenced by multiple interacting factors. The "biopsychosocial" care model has gained popularity in response to growing research evidence indicating the influence of biological, psychological, and social factors on the pain experience. The implementation of this model is a challenge in the practice of the health professional. Objective: To perform the transcultural adaptation of the SCEBS method into Brazilian Portuguese. Methods: The instrument was translated and applied to 50 healthy subjects and 50 participants with non-specific chronic pain in the spine. The process of cross-cultural adaptation included the following steps: transcultural adaptation, content analysis of the scale, pre-test, revision, back-translation review, cross-cultural adaptation, revised text correction and final report. Results: The translated and adapted 51-item Portuguese version of the SCEBS method produced an instrument called SCEBS-BR. In the assessment by the target population, 50 adult users of the Brazilian Unified Health System answered the questionnaire and showed good understanding of the instrument on the verbal rating scale. Conclusion: The SCEBS-BR was proved to be easily understandable, showing good semantic validation regardless of schooling level or age, and can be considered adequate for clinical use.

Resumo Introdução: A dor é uma experiência individual influenciada por aspectos multifatoriais. O modelo de cuidado "biopsicossocial" adquiriu popularidade em resposta à crescente evidência de pesquisas indicando a influência de fatores biológicos, psicológicos e sociais na experiência de dor. A implantação deste modelo é um desafio na prática do profissional de saúde. Objetivo: Realizar a adaptação transcultural do Método SCEBS para o português do Brasil. Métodos: O instrumento foi traduzido e aplicado a 50 indivíduos saudáveis e 50 pacientes com dor crônica não específica na coluna. O processo de adaptação transcultural incluiu as seguintes etapas: adaptação transcultural, análise de conteúdo da escala, pré-teste, revisão, revisão de back-translation, adaptação transcultural, correção de texto revisada e relatório final. Resultados: A versão portuguesa traduzida e adaptada de 51 itens do método SCEBS produziu um instrumento denominado SCEBS-BR. Na avaliação da população-alvo, 50 usuários adultos do Sistema Único de Saúde responderam ao questionário e mostraram boa compreensão do instrumento na escala de classificação verbal. Conclusão: O SCEBS-BR demonstrou ser facilmente compreensível, mostrando boa validação semântica independentemente do nível de escolaridade ou idade e considerado adequado para o uso clínico.

Relationship between paravertebral muscle twitching and long-term effects of radiofrequency medial branch neurotomy

BACKGROUND: To achieve a prolonged therapeutic effect in patients with lumbar facet joint syndrome, radiofrequency medial branch neurotomy (RF-MB) is commonly performed. The purpose of this study was to evaluate the prognostic value of paravertebral muscle twitching when performing RF-MB in patients with lumbar facet joint syndrome. METHODS: We collected and analyzed data from 68 patients with confirmed facet joint syndrome. Sensory stimulation was performed at 50 Hz with a 0.5 V cut-off value. Patients were divided into 3 groups according to the twitching of the paravertebral muscle during 2 Hz motor stimulation: ‘Complete’, when twitching was observed at all needles; ‘Partial’, when twitching was present at 1 or 2 needles; and ‘None’, when no twitching was observed. The relationship between the long-term effects of RF-MB and paravertebral muscle twitching was analyzed. RESULTS: The mean effect duration of RF-MB was 4.6, 5.8, and 7.0 months in the None, Partial, and Complete groups, respectively (P = 0.47). Although the mean effect duration of RF-MB did not increase significantly in proportion to the paravertebral muscle twitching, the Complete group had prolonged effect duration (> 6 months) than the None group in subgroup analysis. (P = 0.03). CONCLUSIONS: Paravertebral muscle twitching while performing lumbar RF-MB may be a reliable predictor of long-term efficacy when sensory provocation under 0.5 V is achieved. However, further investigation may be necessary for clarifying its clinical significance.

An Updated Overview of Low Back Pain Management in Primary Care

Currently, guidelines for lower back pain (LBP) treatment are needed. We reviewed the current guidelines and high-quality articles to confirm the LBP guidelines for the Korean Society of Spine Surgery. We searched available databases for high-quality articles in English on LBP published from 2000 to the present year. Literature searches using these guidelines included studies from MEDLINE, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, and Embase. We analyzed a total of 132 randomized clinical trials, 116 systematic reviews, 9 meta-analyses, and 4 clinical guideline reviews. We adopted the SIGN checklist for the assessment of article quality. Data were subsequently abstracted by a reviewer and verified. Many treatment options exist for LBP, with a variety of recommendation grades. We assessed the recommendation grade for general behavior, pharmacological therapy, psychological therapy, and specific exercises. This information should be helpful to physicians in the treatment of LBP patients.

Efficacy and Safety of Different Aceclofenac Treatments for Chronic Lower Back Pain: Prospective, Randomized, Single Center, Open-Label Clinical Trials

PURPOSE: Nonsteroidal anti-inflammatory drugs are a mainstay for medical treatment of chronic lower back pain (CLBP). Increased dose intervals for medication have been associated with increased patient adherence to prescriptions. The purpose of this clinical trial was to compare the efficacy and safety of a once daily dose of aceclofenac controlled release (CR) and a twice daily dose of aceclofenac for CLBP management. MATERIALS AND METHODS: A prospective, randomized, single center, open-label clinical trial was performed to compare the efficacy and safety of aceclofenac CR (200 mg once daily) to aceclofenac dose (100 mg twice daily). Fifty patients in each group were enrolled for the study. The primary end point was Visual Analogue Scale (VAS) change at baseline to that at 2 weeks after medication and safety profiles. Also, change in quality of life measured by EuroQoL 5D (EQ-5D) and Oswestry Disability Index (ODI) functional score for the lumbar spine were also assessed. RESULTS: Within groups at pre- and post-treatment, there were significant VAS reductions for aceclofenac CR and aceclofenac (p=0.028). EQ-5D increased significantly in both groups (p=0.037). ODI scores decreased significantly in both groups (p=0.012). However, there were no significant differences between aceclofenac CR and aceclofenac at pre- and post-treatment. Patients with aceclofenac CR showed significant increases in heartburn and indigestion and adverse gastrointestinal effects, compared to aceclofenac. CONCLUSION: In patients with CLBP, aceclofenac CR and aceclofenac demonstrated significant symptomatic pain relief, improvement in quality of life and functional scores. Aceclofenac CR slightly increased gastrointestinal adverse effects, such as heartburn and indigestion.